Dear Doctor,
I will be unable to obtain my HAART treatment for one month because I do not have enough money. Is there any serious risk in taking a break from the drugs for one month until I start my new job? My CD4 count is around 268, and my viral load is undetectable. I have been fairly consistent about taking the drugs since I started, one year ago. When I do stop taking the drugs (this is not a matter of if, because there is no way I can find the $1000 before I start working again), should I stop all at once, or should I gradually reduce dosage? Thank you. -- Poverty Stricken

Response from Dr. Feinberg

You are in a tough situation, but never NEVER reduce the dosage gradually -- that will only encourage your HIV to become resistant. If you have an undetectable viral load now, then stop all the drugs at the same time -- your viral load will become detectable and your T cells may slip a bit, but as long as your HIV remains sensitive everything will improve when you have the money to restart your medicines. I empathize -- it's a terrible thing to have to choose between medication and other life essentials. Good luck!

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